In Arizona, particularly in Native American reservations, the community is facing severe poverty, high rates of substance abuse, and significant health disparities. The poverty rate among Native Americans in Arizona is alarmingly high, with 28.6% living in poverty compared to lower rates in other minority groups. This economic hardship is exacerbated by a lack of resources and employment opportunities on reservations, leading to over 8,500 people leaving the Navajo Nation since 2010. Substance abuse is a critical issue, with Native Americans having the highest rates of alcohol, cocaine, and the second-highest methamphetamine abuse rates in the U.S. The rates of binge drinking and illicit drug use are 23.5% and 12.3%, respectively, and the community is five times more likely than whites to die of alcohol-related causes. Fetal alcohol syndrome rates are among the highest in the nation, with some tribes experiencing rates as high as 1.5 to 2.5 per 1,000 live births. Arizona also reports a high rate of missing and murdered Indigenous women and girls, the third-highest in the U.S.

Health disparities are also stark, as American Indians/Alaska Natives (AI/AN) in Arizona, which has the third-largest AI/AN population in the U.S., suffer from lower life expectancy, lower quality of life, and many chronic conditions. Compared to whites, AI/AN had significantly higher prevalence of conditions such as obesity, diabetes, high blood pressure, and fair or poor health status. Education and income levels are lower, and unemployment is higher among AI/AN compared to whites, reflecting the socioeconomic challenges faced by these communities. These conditions, coupled with historical trauma and ongoing marginalization, contribute to a cycle of health and social issues that significantly impact the Native American population in Arizona.